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Published on: August 27, 2019
Case-Control Study of Clostridium innocuum Infection, Taiwan
Abstract:
Vancomycin-resistant Clostridium innocuum was recently identified as an etiologic agent for antibiotic-associated diarrhea in humans. We conducted a case-control study involving 152 C. innocuum-infected patients during 2014-2019 in Taiwan, using 304 cases of Clostridioides difficile infection (CDI) matched by diagnosis year, age (+2 years), and sex as controls. The baseline characteristics were similar between the 2 groups. C. innocuum-infected patients experienced more extraintestinal clostridial infection and gastrointestinal tract-related complications than did patients with CDI. The 30-day mortality rate among C. innocuum-infected patients was 14.5%, and the overall rate was 23.0%. Chronic kidney disease, solid tumor, intensive care unit admission, and shock status were 4 independent risk factors for death. C. innocuum identified from clinical specimens should be recognized as a pathogen requiring treatment, and because of its intrinsic vancomycin resistance, precise identification is necessary to guide appropriate and timely antimicrobial therapy.
Insights
Vancomycin-resistant Clostridium innocuum causes antibiotic-associated diarrhea and severe complications. Prompt identification is crucial for effective treatment due to its resistance to vancomycin.
Area of Science:
- Microbiology
- Infectious Diseases
- Clinical Medicine
Background:
- Emergence of vancomycin-resistant Clostridium innocuum as a cause of antibiotic-associated diarrhea.
- Need to understand the clinical significance and outcomes of C. innocuum infections compared to Clostridioides difficile infection (CDI).
Purpose of the Study:
- To compare clinical characteristics and outcomes of patients infected with C. innocuum versus CDI.
- To identify risk factors for mortality in C. innocuum infections.
Main Methods:
- Case-control study in Taiwan (2014-2019) with 152 C. innocuum cases and 304 CDI controls.
- Matching by diagnosis year, age, and sex.
- Analysis of baseline characteristics, complications, and mortality rates.
Main Results:
- C. innocuum patients had higher rates of extraintestinal clostridial infection and gastrointestinal complications.
- 30-day mortality was 14.5% and overall mortality was 23.0% in C. innocuum infections.
- Independent risk factors for death included chronic kidney disease, solid tumor, ICU admission, and shock.
Conclusions:
- C. innocuum should be recognized as a significant pathogen requiring treatment.
- Intrinsic vancomycin resistance necessitates precise identification for appropriate antimicrobial therapy.
- Timely and accurate diagnosis is critical for managing C. innocuum infections.
